Individual provider Active NPI

Bradford Alan Danley, AGACNP-BC

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1194541995
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
884404 Issued in NV
Practice address
3022 S Durango Dr Ste 100
Las Vegas, NV 89117-4440
Phone
(702) 340-4302
NPI assigned
Nov 26, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 884404 NV Primary

Addresses

Primary practice location

3022 S Durango Dr Ste 100
Las Vegas, NV 89117-4440

Mailing address

911 Squaw Peak Dr
Henderson, NV 89014-0356
Phone (702) 340-4302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251003002146 NV Practitioner - Nurse Practitioner 7911403381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shamloo Blue Sky Treatment Center PLLCGroup PAC ID 8426283417, 5 clinicians

Practice addresses (Care Compare)

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 961-5000

Hospital & facility affiliations

  • Henderson Hospital Hospital, Henderson, NV, CCN 290057
  • Centennial Hills Hospital Medical Center Hospital, Las Vegas, NV, CCN 290054
  • Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003
  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045
  • West Henderson Hospital Hospital, Henderson, NV, CCN 290062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shamloo Blue Sky Treatment Center PLLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

3150 N Tenaya Way
Ste 150
Las Vegas, NV 89128
Phone (702) 240-3198

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1194541995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 SQUAW PEAK DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890140356",
            "telephone_number": "702-340-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3022 S DURANGO DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891174440",
            "telephone_number": "702-340-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANLEY",
        "first_name": "BRADFORD",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "884404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.